Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
William F. Connell School of Nursing, Boston College, Boston, MA.
Semin Nephrol. 2021 Jan;41(1):24-32. doi: 10.1016/j.semnephrol.2021.02.003.
Chronic pain and prescription opioid use are prevalent among patients with end-stage kidney disease treated with hemodialysis. Vulnerabilities to complications from opioid use are high in this patient population, as shown in many recent, well-conducted, patient-oriented studies. Such studies have highlighted the need for a balanced approach to pain management in hemodialysis patients that includes careful assessment of the risks and benefits of opioid prescriptions in this population. In this article, we review the available literature and experience regarding opioid prescriptions among hemodialysis patients, discuss clinical implications, and outline ongoing research.
慢性疼痛和处方类阿片类药物的使用在接受血液透析治疗的终末期肾病患者中较为常见。在这个患者群体中,由于使用阿片类药物引起并发症的脆弱性很高,正如许多最近进行的、精心设计的、以患者为导向的研究所示。这些研究强调了需要在血液透析患者中采取平衡的方法来管理疼痛,包括仔细评估该人群中阿片类药物处方的风险和益处。在本文中,我们回顾了有关血液透析患者阿片类药物处方的现有文献和经验,讨论了临床意义,并概述了正在进行的研究。